The policy to deactivate 11.17 million Contribution Assistance Recipients (PBI) within the BPJS Kesehatan system has sparked widespread public concern. The measure has been described as part of the updating process of the National Integrated Socioeconomic Data (DTSEN) to ensure that health subsidies are more accurately targeted within the framework of the National Health Insurance (JKN) program.
However, behind the spirit of efficiency and data accuracy, a major question arises: has this policy been implemented with sufficient consideration for humanitarian dimensions and citizens’ constitutional rights?
Professor of the Department of Health Administration and Policy at the Faculty of Public Health (FPH), Universitas Indonesia, Prof. dr. Adang Bachtiar, M.P.H., D.Sc., believes that in principle, updating the data is indeed necessary. “The state must ensure that subsidies are properly targeted. Data integration and updating are part of good governance,” he stated.
Nevertheless, Prof. Adang emphasized that the core issue lies not in the policy’s intention, but in the timing and method of its implementation. According to him, the deactivation was carried out while the revalidation and reactivation systems were not yet fully prepared. As a result, some participants—including patients with chronic illnesses such as kidney failure—found their membership status inactive when attempting to access routine dialysis services.
“In health policy, continuity of care is a fundamental principle. Administrative corrections must not disrupt access to treatment,” stressed Prof. Adang.
From a governance perspective, Prof. Adang also argued that the deactivation procedures have not fully met the principles of good governance. Many participants did not receive prior official notification and only discovered their inactive status when they were denied services at healthcare facilities. This condition, he said, undermines the principles of legal certainty and due process, and potentially contradicts the constitutional guarantee of the right to health as stipulated in Article 28H of the 1945 Constitution.
The government has expressed its commitment to carrying out selective reactivation, particularly for participants with catastrophic illnesses and low-income groups mistakenly affected by the policy. However, the process is still considered partial. Reactivation remains dependent on field verification by regional social service offices and requires additional administrative procedures. In several regions, limited human resources and budget constraints pose significant challenges.
“Illness does not wait for administrative processes to be completed. A health insurance system must be able to respond quickly and automatically, especially for vulnerable groups,” said Prof. Adang.
Furthermore, he warned that the impact of this policy extends beyond technical healthcare service issues. Public trust in the JKN program and the government may erode if people feel that their right to health is insecure. In the long term, declining trust could also affect public participation in other social programs.
As a way forward, Prof. Adang recommended several strategic measures. First, mass deactivation should be postponed until the revalidation process is fully completed, while ensuring that healthcare services continue uninterrupted. Second, automatic reactivation should be implemented for chronic patients, the elderly, and vulnerable groups without complicated layered procedures. Third, transparency must be strengthened through clear notification mechanisms and fast, easily accessible appeal channels. In addition, the capacity of regional social service offices needs to be reinforced, and real-time data integration between healthcare facilities and BPJS has become an urgent necessity to prevent patients from being denied treatment in critical conditions.
“Data updating is essential in a modern system. But health is not merely a budgetary variable. It concerns human lives and dignity,” concluded Prof. Adang.
Amid the government’s efforts to improve subsidy governance, academics continue to remind policymakers that fiscal sustainability must go hand in hand with the protection of citizens’ fundamental rights. Reform is indeed important, but humanity must remain the primary foundation of national health policy. (wrk)